The conflict in Syria has developed into one of the worst of the twenty-first century. In ten years, more than half of the population of Syria has been displaced, hundreds of thousands killed, tortured, and many more injured and living under dire conditions.March 2021 marked the tenth anniversary of the start of the civil uprising. Intense reflection is necessary if the second decade of the Syrian conflict is to be more successful than the first.
The Syrian conflict is becoming one that people are slowly forgetting. The conflict is misunderstood even though it has been ongoing for over a decade.(1,2)Recent documentary films have shed light on the life stories of activists who took on humanitarian civil society roles after the militarisation of the conflict.(3,4)These activities provided the basis for Syrian civil society work and the ensuing medical and humanitarian response.
Healthcare workers played an essential role in the response to the humanitarian situation. Due to the delayed international response and rising needs early in the conflict, local Non-Governmental Organisations (NGOs) were founded by expatriate healthcare workers in Europe and the US to provide health aid inside Syria.(5) There was little civil society in Syria before the conflict and NGOs had to upscale their structure rapidly to meet increasing needs.International healthcare workers also played an important role, providing much needed specialist services and aiding educational efforts. To make best use of what limited resources were made available and, in an effort, to protect medical volunteer efforts from fragmentation, local Syrian healthcare workers formed ‘Syrian Health Directorates’ to coordinate aid and govern the health needs of the population.
These efforts occurred against a backdrop of a ‘weaponisation of healthcare’. With the development of the war in Syria, the regime identified healthcare workers and facilities as a strategic target of war. More than 900 healthcare workers were killed in 600 separate attacks.(20) Attacks against healthcare have been known to occur in contexts outside Syria and have intensified in the last two decades. At one point, however, Syria accounted for 70% of attacks against healthcare worldwide. In addition to the scale of attacks, the regime used attacks against healthcare as a deliberate military tactic against civilian targets to ‘induce submission of civilian populations [in opposition held areas] and break their resilience’.(10)